Cannabinoid hyperemesis syndrome: an important differential diagnosis of persistent unexplained vomiting

  title={Cannabinoid hyperemesis syndrome: an important differential diagnosis of persistent unexplained vomiting},
  author={James K Ruffle and Sanjin Bajgoric and Kiran Samra and Subashini Chandrapalan and Qasim Aziz and Adam D. Farmer},
  journal={European Journal of Gastroenterology \& Hepatology},
Introduction Chronic nausea and vomiting have a detrimental impact on quality of life. When standard diagnostic investigations fail to provide a definitive diagnosis, patients are often attributed as having a functional gastrointestinal disorder such as cyclic vomiting syndrome. Cannabinoid hyperemesis syndrome (CHS) is a relatively recently described entity presenting with symptoms similar to cyclic vomiting syndrome. Methods We carried out a retrospective cohort study of all patients… 
Cyclic vomiting syndrome: a case series and review of the literature
The experience of treating patients with amitriptyline is reported, and proposed pathophysiologies include neuroendocrine dysfunction, mutations in mitochondrial DNA and re-intoxication effects from cannabis stored in fat tissues are proposed.
Cannabinoid hyperemesis syndrome presentation to the emergency department: A two-year multicentre retrospective chart review in a major urban area.
This study suggests that Cannabinoid hyperemesis syndrome (CHS) may be an overlooked diagnosis for nausea and vomiting, a factor that can possibly contribute to unnecessary investigations and treatment in the ED.
Cannabis hyperemesis syndrome: an update on the pathophysiology and management
The role of the ECS, its management, and the identification of gaps in the current knowledge of CHS are elaborate to further enhance its understanding in the future.
An overview of the clinical management of cyclic vomiting syndrome in childhood
Abstract This narrative review provides an update on cyclic vomiting syndrome pathogenesis, diagnosis and management, based upon studies published after the 2008 North American Society for Pediatric
Cannabinoid Hyperemesis
Cannabinoid hyperemesis syndrome (CHS) is a paradoxical condition in which a long-term cannabis user suffers an episode of intractable vomiting that may last days separated by longer asymptomatic
Role of chronic cannabis use: Cyclic vomiting syndrome vs cannabinoid hyperemesis syndrome
  • T. Venkatesan, D. Levinthal, W. Hasler
  • Medicine, Psychology
    Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
  • 2019
The role of cannabis in the regulation of nausea and vomiting, specifically focusing on both CVS and CHS, is discussed, in order to address controversies in this context and identify limitations in the existing diagnostic framework.
Cannabinoid hyperemesis syndrome and the onset of a manic episode
It is suggested that a 3-week period of vomiting in the context of this syndrome contributed to the precipitation of a manic episode by lowering mood stabiliser serum levels, and that this syndrome will have significant consequences for the patient's mental health.
Emerging Role of Aprepitant in Cannabis Hyperemesis Syndrome
A case study is reported where aprepitant (Emend) was successfully used as an anti-emetic in the treatment of CHS when all other commonAnti-emetics failed.
[Beneficial Effect of Medical Cannabis in the Treatment of a Pharmacoresistant Nausea Associated with a Somatoform Disorder in a Patient with Post-Polio Syndrome].
Cannabis is a treatment option for treatment-resistant symptoms as part of a post-polio syndrome and under the therapy there was a relief of the nausea symptoms and decreased pain.
Gastric Electrical Stimulation Is an Option for Patients with Refractory Cyclic Vomiting Syndrome
In a small group of drug-refractory CVS patients, treatments with temporary and permanent GES significantly reduced the severity of gastrointestinal symptoms and frequency of hospital admissions.


Cannabinoid Hyperemesis Syndrome
With the increasing use of cannabis among all manner of age groups, especially recreationally among adolescents as well as medically for use as an antiemetic in chemotherapy-induced vomiting, appetite stimulant in those with cachexia, and analgesic and as an antispasmodic in multiple sclerosis, it is important to recognize this phenomenon's risk factors and presentation in both emergency and primary care.
Cyclic vomiting syndrome in 28 patients: demographics, features and outcomes
Antimigraine medication, &bgr;-blockers and antiepileptic treatment may be successful at attenuating attacks; however, in this long-term study, the prognosis of patients not treated with these medications was also good.
Cannabinoid hyperemesis syndrome: clinical diagnosis of an underrecognised manifestation of chronic cannabis abuse.
In the setting of chronic cannabis abuse, patients presenting with chronic severe nausea and vomiting that can sometimes be accompanied by abdominal pain and compulsive hot bathing behaviour, in the absence of other obvious causes, a diagnosis of cannabinoid hyperemesis syndrome should be considered.
Cannabinoid hyperemesis: a case series.
Cannabinoid Hyperemesis Syndrome: A Cause of Refractory Nausea and Vomiting in Pregnancy
Cannabinoid hyperemesis syndrome should be considered in pregnant women with intractable nausea relieved by frequent hot bathing, and extensive diagnostic testing can be avoided and the correct therapy, abstaining from cannabis use, can be recommended.
The Cannabis Hyperemesis Syndrome Characterized by Persistent Nausea and Vomiting, Abdominal Pain, and Compulsive Bathing Associated with Chronic Marijuana Use: A Report of Eight Cases in the United States
Cannabis hyperemesis is characterized by otherwise unexplained recurrent nausea and vomiting, compulsive bathing, abdominal pain, and polydipsia associated with chronic cannabis use, which can occur in the United States as well as in Australia.